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General NPI Number Information
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NPI Number | 1851422604
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Entity Type | Individual
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Provider Name | VICKI L MOSS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1395 ATWOOD AVE SUITE 213
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City | JOHNSTON
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State | RI
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Zip | 02919-4929
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Country | US
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Telephone | 401-944-9888
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Fax | 401-944-5888
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Provider Business Mailing Address
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Address Line | 74 CHARLES HARPIN RD
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City | FOSTER
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State | RI
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Zip | 02825-1100
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Country | US
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Telephone | 401-627-7189
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 208
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License Number State | RI
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